The
reach of work by Emory’s doctors, nurses, and
public health practitioners extends throughout the globe.

The risk of HIV transmission due to blood transfusion
approaches one in 500 in some developing countries (compared with
one in 5 million in the United States). The World Health Organization
estimates that 5% to 10% of HIV infections worldwide are caused by
transfusion of unsafe blood and blood products and that the percentage
is considerably higher in many African nations where blood products
are seldom tested and the majority of hospitals have no transfusion
policies or procedures to limit HIV transmission. More than half of
all blood transfused in Africa is given to children. The dangers of
transmitting AIDS in transfused blood may be changing, thanks in part
to the efforts of Emory Healthcare’s Christopher Hillyer, director
of the Emory Transfusion Medicine Program and President-Elect of the
American Association of Blood Banks. Hillyer is the co-principal investigator
of a five-year grant funded by the President’s Emergency Plan
for AIDS relief to improve the safety of blood transfusion in Kenya,
South Africa, Mozambique, and Guyana.

In Kenya, large numbers of young nurses are dying
of AIDS. That’s one reason this and other countries hardest
hit by poverty and disease have fewer and fewer nurses to hold together
already fragile health care structures. Another reason is that richer
countries regularly recruit Kenya’s nurses away in an effort
to solve their own countries’ worsening nurse shortages. The
Nell Hodgson Woodruff School of Nursing’s Lillian Carter Center
for International Nursing—created precisely to strengthen the
global capacity of nurses to improve the health of vulnerable people
worldwide—works closely with governmental chief nursing officers
in Kenya and more than 80 countries to help reverse the flow of nurses
from the very countries that need them most.

Georgia—the one in the former Soviet Republic—has
bestowed honorary citizenship on Kenneth Walker, the Emory medicine
and neurology professor who heads the Atlanta-Tbilisi Health Care
Partnership. Created by Emory 15 years ago to improve the education
and health care systems in this struggling country, the partnership
includes Emory’s schools of medicine, nursing, and public health,
as well as Georgia State University, Morehouse School of Medicine,
Grady Memorial Hospital, and Georgia Institute of Technology. Over
the years, all these institutions have sent faculty back and forth
to the other Georgia, but none have made the trip more often than
Walker. He exemplifies Emory’s broad-scale commitment to bringing
this and other developing nations the information, technology, and
training they need to improve health care for their own citizens.
Program areas range from providing training in emergency medical services
and in maternal and child health to helping get prosthetics for an
estimated 10,000 lower-limb amputees, half of whom were injured in
land mine explosions.

Malnutrition during pregnancy and in childhood often
has devastating long-term effects on physical and intellectual development
of the individual and, if widespread, on the health and functioning
of the nation. Even the failure to obtain sufficient amounts of specific
minerals or vitamins during pregnancy—a nickel’s worth
of iodine, easily packaged in iodized salt—can result in severe
retardation and other birth defects. The Rollins School of Public
Health has had a major impact on the nutrition and consequent health
of children and adults. Rey Martorell’s research on the effects
of improved nutrition during pregnancy and early childhood, conducted
over three decades in Central America, has had a major influence on
the policies of international organizations such as UNICEF, the World
Bank, and the World Food Program. Glen Maberly, founder and director
of the Program Against Micronutrient Malnutrition, has been given
a share of the credit for the elimination of iodine deficiency in
children in China, and Fritz van der Haar heads the network for Sustained
Elimination of Iodine Deficiency, a global alliance of 10 international
organizations working toward universal salt iodization. Work by other
faculty in public health on a Flour Fortification Initiative, sponsored
by UNICEF and the CDC, seeks to improve micronutrient status of global
populations through fortification of wheat flour.

The Atlanta Rotary recently joined forces with the
Rollins School of Public Health’s Center for Global Safe Water
to build new wells and support safe water treatment and storage in
Kenya. The joint effort was inspired by problems in many villages
in the struggling country where lack of easy access to clean water
means children must spend hours carrying water instead of going to
school and poor sanitation causes life-threatening disease. The effort
also was inspired by the success of an inexpensive but effective water
purification program, sponsored by the CDC and CARE, in which poor
Kenyan women borrow enough money to buy a purifying chlorine solution
wholesale and sell it retail to their neighbors. The program works.
It gives the women (sometimes called the Avon ladies of Kenya) unprecedented
economic power and already has cut in half the number of cases of
diarrhea in children under 5, those least likely to survive serious
bouts of the disease.
Faculty in public health are also working to build better latrines
in places like El Salvador to help conserve water, prevent pollution,
and reduce childhood illness and death.